AB1508 ANXIETY AND DEPRESSION IN PATIENTS WITH FMF
Authors: B. Egeli, O. Kilinc, A. Kilinc, F. N. Azman, S. Ardac, S. Ugurlu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Familial Mediterranean Fever (FMF) is a systemic autoinflammatory disease requiring lifelong treatment, characterized by recurrent episodes of fever, arthritis, and serositis. Recent studies denote an association between FMF and behavioral disorders such as anxiety and depression<sup>[1]</sup>. Further investigations are needed to have a better understanding of the relationship of FMF to anxiety and depression. <h3>Objectives</h3> In this study, we aimed to assess anxiety and depression among FMF patients and their relation to different variables such as gender, age, genotype, drug compliance, biologic treatment, family history of FMF, age of first colchicine dose, age of symptom onset, degree of education, and monthly income. <h3>Methods</h3> We surveyed 360 (225 F, 135 M) FMF patients in our outpatient clinic between June and October 2022. Our surveys included different inventories assessing anxiety and depression which were as follows: Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and State-Trait Anxiety Inventory (STAI). We then compared the inventory scores according to different variables. <h3>Results</h3> The median age for the patients was 36.4 ± 11.0 (19-64). Median scores for STAI-Y1 (state), STAI-Y2 (trait), BAI, and BDI were 42.2 ± 12.0, 45.9 ± 10.6, 24.0 ± 13.9, and 13.1 ± 8.99 respectively. There was no significant difference between male and female patients on STAI-Y1, STAI-Y2, and BDI but females scored significantly higher on BAI (25.8 ± 13.7 vs 21.0 ± 13.9, p-value: 0.001). Drug compliant patients had significantly lower scores on STAI-Y1 (41.5 ± 11.4 vs 45.2 ± 14.0, p-value:0.04) compared to non-compliant patients but their scores did not significantly differ on STAI-Y2, BAI, and BDI. M694V homozygous patients got significantly lower scores from BAI and BDI (17.0 ± 12.1 vs 25.1 ± 13.9, p-value: &lt;.001; 12.4 ±9.37 vs 13.2 ±8.93, p-value: &lt;.001). Exon-2 mutation positive patients scored significantly higher on BAI (29.6 ± 13.3 vs 21.6 ± 13.5, p-value: &lt;.001) but did not get significantly different scores from STAI-Y1, STAI-Y2, and BDI compared to Exon-2 mutation negative patients. The patients with Exon-10 mutation get significantly lower scores on BAI (17.9 ± 12.3 vs 27.3 ± 13.7, p-value: &lt;.001) but positivity of Exon-10 mutation did not affect the STAI-Y1, STAI-Y2, and BDI scores significantly. Different groups of educational levels (uneducated, elementary school, secondary school, high school, university) got significantly different scores, low level groups getting higher scores, from STAI-Y2 (56.6 ± 6.80, 48.3 ± 11.6, 43.4 ± 11.0, 45.5 ± 8.63, 45.2 ± 11.2, p-value: 0.002) but all groups scored similarly on STAI-Y1, BAI, and BDI. Different groups of monthly income (&lt;$340, $ 340-680, $ 680-1130, $ 1130+) had significantly different scores from STAI-Y2, BAI, and BDI [(46.7 ± 10.4, 45.8 ± 10.7, 40.8 ± 12.1, 41.3 ± 6.31, p-value: 0.022), (26.1 ± 13.6, 20.9 ± 13.7, 20.1 ± 13.9, 26.2 ± 16.7, p-value: 0.004), (14.0 ± 9.16, 12.2 ± 8.64, 9.88 ± 8.55, 12.3 ± 7.89, p-value: 0.034)] whereas they all had similar scores from STAI-Y1. Having a family member with FMF, biologic agent treatment, age of onset for symptoms, and the colchicine starting age did not have a significant impact on the scores taken from all four inventories. <h3>Conclusion</h3> Our patients had moderate anxiety according to BAI scores, and severe state and trait anxiety according to STAI-Y1, STAI-Y2 scores all of which indicates the presence of anxiety. Medication compliant patients had lower levels of anxiety. We argue that this difference was due to better disease control because of drug compliance. Furthermore, BDI scores indicated mild depression among patients. In addition, M694V homozygous patients interestingly had lower anxiety and depression levels. Further investigations are necessary to understand the effect of different variables on anxiety and depression in FMF patients. <h3>Reference</h3> [1]Lidor I, Tiosano S, Sharif K, Amital H, Cohen AD, Amital D. The risk of depression and anxiety in patients with familial mediterranean fever - a cross-sectional study. J Affect Disord. 2021 Sep 1;292:695-699. doi: 10.1016/j.jad.2021.05.113. Epub 2021 Jun 6. PMID: 34157665. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.